School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
PLoS One. 2024 Jan 30;19(1):e0297221. doi: 10.1371/journal.pone.0297221. eCollection 2024.
Multimorbidity, which is defined as having at least two or more chronic diseases concurrently, has been a rising public health issue in recent years in Canada and worldwide. The increasing prevalence of multimorbidity has posed a burden on the current health care system and quality of life for the Canadian population. There is a lack of up-to-date research on determinants of multimorbidity in the Canadian population, which is necessary to better understand and prevent multimorbidity. This study aims to determine the prevalence and risk factors of multimorbidity in the middle-aged and older Canadian adult population. Multivariable logistic regression analyses incorporating survey weights and biologically plausible interactions were conducted to examine the determinants of multimorbidity using data from the 2017/2018 Canadian Community Health Survey (CCHS). Of the 113,290 CCHS participants, 82,508 subjects who were aged 35 years and above were included in the study. The prevalence of multimorbidity was 22.20% (95% CI: 21.74%, 22.67%) and was greater for females. Multimorbidity was more likely in subjects who were obese, abstaining from alcohol, inactive, had a lower education level, widowed, divorced, or separated and was less likely among subjects living in Quebec. The protective effect of household income on multimorbidity decreased with age. Current smokers who reported extreme stress were more likely to have multimorbidity. Multimorbidity is associated with various determinants that need to be considered in chronic disease control and prevention. These results suggest that future research should focus not only on these determinants but also on the relationships between them. A future longitudinal study is required to provide causal evidence for the study findings.
多病共存,即同时患有两种或两种以上的慢性疾病,近年来已成为加拿大乃至全球公共卫生的一个日益严重的问题。多病共存的患病率不断上升,给加拿大当前的医疗保健系统和民众的生活质量带来了负担。加拿大人口多病共存的决定因素缺乏最新的研究,这对于更好地了解和预防多病共存是必要的。本研究旨在确定加拿大中年和老年成年人多病共存的患病率和危险因素。采用 2017/2018 年加拿大社区健康调查(CCHS)的数据,通过包含调查权重和生物学合理相互作用的多变量逻辑回归分析,研究了多病共存的决定因素。在 113290 名 CCHS 参与者中,有 82508 名年龄在 35 岁及以上的受试者被纳入研究。多病共存的患病率为 22.20%(95%CI:21.74%,22.67%),女性患病率更高。在肥胖、不饮酒、不活跃、教育程度较低、丧偶、离婚或分居的人群中,多病共存的可能性更大,而在魁北克省居住的人群中,多病共存的可能性更小。家庭收入对多病共存的保护作用随着年龄的增长而降低。报告极度压力的当前吸烟者更有可能患有多病共存。多病共存与各种决定因素相关,这些因素需要在慢性病控制和预防中加以考虑。这些结果表明,未来的研究不仅应关注这些决定因素,还应关注它们之间的关系。需要进行未来的纵向研究,为研究结果提供因果证据。